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Endoscopic transpapillary stenting for pancreatic fistulas after necrosectomy with necrotizing pancreatitis

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Abstract

Background

Data concerning the incidence and treatment of pancreatic fistula after necrosectomy in severe acute necrotizing pancreatitis (SAP) are scarce. Our aim was to assess the incidence of pancreatic fistula, and the feasibility and results of endoscopic transpapillary stenting (ETS) in patients with SAP after necrosectomy.

Methods

From January 2009 to December 2012 twenty-nine consecutive patients with SAP and necrosectomy in Oulu University Hospital were enrolled into this study. Five patients died before ETS because of the rapid progress of the disease and were, therefore, excluded.

Results

ERP was performed for the remaining 24 patients demonstrating fistula in 22/24 patients (92 %). ETS was successful in 23 patients and the fistula closed in all of them after a median of 82 (2–210) days with acceptable morbidity and no procedure-related mortality.

Conclusion

All patients after necrosectomy for SAP seem to have internal or external pancreatic fistula. EST aimed at internal drainage of the necrosectomy cavity is a feasible and effective therapy in these patients.

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Disclosures

Drs. Heikki Karjula, Arto Saarela, Anne Vaarala, Jarmo Niemelä and Jyrki Mäkelä have no conflicts of interests or financial ties to disclose.

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Authors and Affiliations

  1. Gastrointestinal Surgery Division, Department of Surgery, Oulu University Hospital, OYS, BOX 21, 90029, Oulu, Finland

    Heikki Karjula, Arto Saarela, Jarmo Niemelä & Jyrki Mäkelä

  2. Department of Radiology, Oulu University Hospital, Oulu, Finland

    Anne Vaarala

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  1. Heikki Karjula
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  2. Arto Saarela
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  3. Anne Vaarala
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  4. Jarmo Niemelä
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Correspondence to Heikki Karjula.

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Karjula, H., Saarela, A., Vaarala, A. et al. Endoscopic transpapillary stenting for pancreatic fistulas after necrosectomy with necrotizing pancreatitis. Surg Endosc 29, 108–112 (2015). https://doi.org/10.1007/s00464-014-3645-0

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  • DOI: https://doi.org/10.1007/s00464-014-3645-0

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